A Quality Improvement Project to Improve Knowledge of the Cost of Single-Use Endoscopy Devices in a University-Based Endoscopy Center

Cotton, C. C.; Gangarosa, L. M.

Background: Single use endoscopy devices comprise a significant burden of expense to endoscopy units and many devices are not separately chargeable. Quality improvement projects in surgical settings have improved participants’ knowledge of the cost of surgical tools and subsequently reduced expenditures, but no such projects have been described in the case of single-use endoscopy devices. Methods: We performed a quality improvement project with the plan-do-study-act framework to assess and improve participants’ knowledge of the cost of single-use endoscopy devices. We assessed baseline knowledge of the cost of 20 different devices with a questionnaire. We then utilized two interventions, an active intervention at one site and a passive intervention at 2 sites. At the active intervention site, endoscopy nurses called out the cost of each single-use endoscopy device used in each case, while at the passive sites we displayed posters that listed the name, cost, and image of each devices. The intervention was performed for 60 days, and then a follow-up questionnaire was administered. We performed random effects Poisson regression for pairwise comparisons of accuracy with 15% and 30% error thresholds. Results: There were 38 participants at baseline and 19 (50%) completed the follow-up questionnaire and were included for analysis. The COVID pandemic did delay the intervention phase resulting in loss of some study participants due to relocation. Participants were within 15% of the actual device cost for a mean 2.4 devices out of 20 at baseline and a mean 4.6 devices at follow-up (p = 0.01). Participants were within 30% of the actual device cost for a mean 3.8 devices out of 20 at baseline and a mean 6.1 devices at follow-up (p = 0.04). This improvement was primarily concentrated among endoscopy staff (Figure 1) and among commonly used devices (Figure 2). Conclusion: Assessment of knowledge of device prices amongst GI fellows, attendings and endoscopy staff was found to be poor at baseline. Neither intervention strategy to enhance knowledge was particularly successful over a 60 day timeframe, except in a select few individuals. A multi-pronged educational approach over a longer timeframe may be necessary to improve pricing knowledge. [Formula presented] [Formula presented]